胆道支架术联合熊去氧胆酸对难治性胆总管结石的疗效和安全性Meta分析  

The Efficacy and Safety of Ursodeoxycholic Acid Combined with Biliary Stents in the Treatment of Refractory Choledocholithiasis:A Meta-analysis

作　　者：朱宏平 邹文哲 黄志英 张卫芳[1] ZHU Hongping;ZOU Wenzhe;HUANG Zhiying;ZHANG Weifang(The Second Affiliated Hospital of Nanchang University,Nanchang Jiangxi 330006,China;Fuzhou Medical College of Nanchang University,Fuzhou Jiangxi 344099,China.)

机构地区：[1]南昌大学第二附属医院,江西南昌330006 [2]南昌大学抚州医学院,江西抚州344099

出　　处：《药品评价》2024年第11期1316-1319,共4页Drug Evaluation

摘　　要：目的 探究胆道支架术后给予熊去氧胆酸(UDCA)对难治性胆总管结石再次取石成功的临床效果和安全性。方法 利用计算机在PubMed、中国知网、维普和万方等中、外数据库中进行全面文献检索,检索时间为建库至2023年11月15日。选取取石成功率作为有效性评价指标,并发症发生率作为安全性评价指标。筛选符合要求的文献并对数据进行提取,将得到的数据运用Review Manager 5.3软件进行荟萃分析。结果 根据纳排标准,最终5篇文献,共计338例患者纳入荟萃分析。结果显示,与对照组相比,UDCA组再次取石成功率显著高于对照组(RR=1.21,95%CI=1.07~1.36,P=0.002,I~2=5%);且两组并发症发生率无显著差异(RR=0.76,95%CI=0.47~1.23,P=0.27,I~2=0%)。结论 置入胆道支架基础上联合UDCA能显著提高难治性胆总管结石的取石成功率,且安全性高。Objective To explore the clinical effect and safety of ursodeoxycholic acid(UDCA)in the treatment of refractory choledocholithiasis after biliary stenting.Methods Literature search was conducted in PubMed,CNKI,VIP and Wanfang databases by computer,and the search time was from the establishment of the database to November 15,2023.The success rate of stone removal was selected as the evaluation index of effectiveness and the complication rate as the evaluation index of safety.After obtaining relevant data,Review Manager 5.3 software was used for meta-analysis of the data.Results According to the exclusion criteria,a total of 338 patients were included in the final five articles for meta-analysis.The results showed that compared with the control group,the success rate of reextraction in UDCA group was significantly higher(RR=1.21,95%CI=1.07~1.36,P=0.002,I2=5%).There was no significant difference in the incidence of complications between the two groups(RR=0.76,95%CI=0.47~1.23,P=0.27,I2=0%).Conclusion Combined administration of UDCA with biliary stent implantation can significantly improve the success rate of refractory choledocholithiasis with good safety.

关 键 词：熊去氧胆酸 胆管支架 胆总管结石 META分析 

分 类 号：R65[医药卫生—外科学]